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These detections have generally been small in quantity with the powders containing a range of different substances – always ketamine and MDMA, and typically additional substances including cocaine, caffeine or cathinone

Wastewater data also reflect the predominant use of ecstasy in recreational settings, with more than three quarters of cities reporting that higher loads of MDMA were present in wastewater during the weekend than during weekdays in 2022. While the number of tablets used per session has not changed substantially from literature findings dating from several decades ago, today’s MDMA users generally ingest higher quantities of the psychoactive substance than before (Gremeaux, 2022). This data explorer enables you to view our data on the prevalence of MDMA use by recall period and age range.


The total quantity of MDMA consumed in Europe is reached by multiplying the number of users by the amount used, combining prevalence data from general population surveys and the amount used from the EWSD. The basic approach used to estimate the value of the European MDMA market is to gauge the quantity of MDMA consumed in Europe and multiply it by its price (EMCDDA, 2019a). Wastewater data also reflect the predominant use of ecstasy in recreational settings, with more than three quarters of cities reporting that higher loads of MDMA were present in wastewater during the weekend than during weekdays in 2022. This data explorer enables you to view our data on the prevalence of MDMA use by recall period and age range. Of the 69 cities that have data for 2022 and 2023, 42 reported an increase, 11 reported a stable situation and 16 a decrease. Wastewater data from 2023 complement the available data from general population surveys, drug treatment and hospital emergency admissions; however, wastewater is not uniformly analysed across the European Unio


Adulteration of MDMA occurs by adding other psychoactive substances, typically stimulants, to MDMA in tablet, powder or crystal form. PMK glycidate, first reported in Europe in 2013, had a particular role in this resurgence (see Section Production - designer precursors substitute scheduled MDMA starting materials). In 2009 and the following years, it was therefore unlikely that consumers who purchased ecstasy in Europe would obtain unadulterated MDMA. In 2009, on average, only 31 % of the tablets analysed contained MDMA alone, compared with almost 100 % in 2004. This includes law enforcement pressure, a variety of factors affecting MDMA production, such as the availability of MDMA precursors, and, more generally, globalisation of the illicit drug supply chain


Together, these two data sources suggests that the large majority of MDMA users buy mdma the drug themselves, and that a smaller proportion obtains it for free, despite marked differences among EU countries. Despite their image as risk-taking hedonists, people who use drugs recreationally do seek out and share harm reduction strategies, often alongside ‘pleasure maximisation’ strategies (the latter often requiring considerable knowledge of drug research, policy and practice). Given the right information and opportunities, most people who use drugs will make rational risk-management decisions when they do so. Given the option, it is clear that people who use MDMA and other drugs will embrace harm reduction approaches, and support their development. Harm reduction is not a principle that policy makers will need to force upon people who use MDMA or other drugs in nightlife and party settings. Significant numbers of people not only like MDMA’s effects and are willing to take known risks (health and legal) to enjoy them, but they seem to prefer it to most available substitute

The share of acute drug-toxicity presentations involving MDMA increased as compared to other substances and the previous year (or MDMA was reported for the first time) in 10 of the Euro-DEN hospitals. When using wastewater data to estimate MDMA markets, the use of MDMA is based on the excreted parent drug, rather than on an excreted metabolite (which is the case for some other drugs, such as cocaine and heroin). Demand-based estimates may underestimate the size of drug markets for a number of reasons, including difficulty reaching some groups of users, and underreporting of prevalence and quantities used by respondents. Estimates of amounts used suggest that about 72.4 million ecstasy tablets were consumed in the European Union in 2021. The total quantity of MDMA consumed in Europe is reached by multiplying the number of users by the amount used, combining prevalence data from general population surveys and the amount used from the EWSD. Information gathered in the 2021 EWSD suggests that, on average, those who reported having used MDMA in the last 12 months, consumed one ecstasy tablet or 0.4 grams of MDMA in crystal or powders form each time they used the drug.
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